Usual Protein Intake Amount and Sources of Nursing Home Residents with (Risk of) Malnutrition and Effects of an Individualized Nutritional Intervention: An enable Study

Abstract

Nursing home (NH) residents with (risk of) malnutrition are at particular risk of low protein intake (PI). The aim of the present analysis was (1) to characterize usual PI (total amount/day (d) and meal, sources/d and meal) of NH residents with (risk of) malnutrition and (2) to evaluate the effects of an individualized nutritional intervention on usual PI. Forty residents (75% female, 85 ± 8 years) with (risk of) malnutrition and inadequate dietary intake received 6 weeks of usual care followed by 6 weeks of intervention. During the intervention phase, an additional 29 ± 11 g/d from a protein-energy drink and/or 2 protein creams were offered to compensate for individual energy and/or protein deficiencies. PI was assessed with two 3-day-weighing records in each phase and assigned to 4 meals and 12 sources. During the usual care phase, mean PI was 41 ± 10 g/d. Lunch and dinner contributed 31 ± 11% and 32 ± 9% to daily intake, respectively. Dairy products (median 9 (interquartile range 6–14) g/d), starchy foods (7 (5–10) g/d) and meat/meat products (6 (3–9) g/d) were the main protein sources in usual PI. During the intervention phase, an additional 18 ± 10 g/d were consumed. Daily PI from usual sources did not differ between usual care and intervention phase (41 ± 10 g/d vs. 42 ± 11 g/d, p = 0.434). In conclusion, daily and per meal PI were very low in NH residents with (risk of) malnutrition, highlighting the importance of adequate intervention strategies. An individualized intervention successfully increased PI without affecting protein intake from usual sources.

Protein intake and bone health: an umbrella review of systematic reviews for the evidence-based guideline of the German Nutrition Society

“…In this context, it is notable that in community-dwelling older adults, the prevalence of a protein intake below 0.8 g/kg BW/day is substantial (14–30%) and increases to 65–76% if a cut-off value of 1.2 g/kg BW/day is considered [ 35 , 36 ]. The situation seems to be even worse in nursing home residents, where a mean daily protein intake of only 0.7 g/kg BW has been reported [ 37 ]. Thus, the high risk of hip fractures in older adults, and particularly in nursing home residents, may, at least in part, be increased by a protein intake below the current recommendation.…”

A web-based novel prediction model for predicting depression in elderly patients with coronary heart disease: A multicenter retrospective, propensity-score matched study

“…Low blood urea nitrogen levels in elderly patients with CHD may be attributed to insufficient intake of protein-rich foods such as fish, meat and eggs, resulting in a negative nitrogen balance and reduced concentrations of blood urea nitrogen, a metabolite of protein. A large number of studies have confirmed that insufficient protein intake will lead to malnutrition ( 40 – 43 ). Meanwhile, a recent study showed that depression and malnutrition were found to be risk factors for adverse outcomes in patients with CHD ( 44 ).…”

Effects of an individualised nutritional intervention to tackle malnutrition in nursing homes: a pre-post study

“…In the present analysis, energy and protein intake from usual food sources as well as from supplementation did not change within the intervention phase (Table 2 ). In a secondary data analysis, limited to residents receiving a supplementation ( n = 40), we examined the effects of the intervention on protein intake in more detail and identified that the supplementation did not affect protein intake amount and sources from regular food components during the intervention phase compared to the usual care phase [ 23 ].…”

“…Usual nutritional care is described in detail in Supplement Fig. S1 and in previous publications [ 20 , 23 ]. Briefly, residents received three main meals (breakfast, lunch and dinner) and additional snacks, delivered from the central kitchen.…”